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Sallerfors B, Nordenfelt I, Ohlsson O. Venous volume in offspring of hypertensive patients. ACTA MEDICA SCANDINAVICA 2009; 216:361-7. [PMID: 6240192 DOI: 10.1111/j.0954-6820.1984.tb03819.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Twenty normotensive healthy male offspring of hypertensive patients were compared to 20 adequate controls regarding venous volume, the effect of ouabain on venous volume and signs of left ventricular hypertrophy. Among offspring there were slightly increased amplitudes in the orthogonal ECG as compared to controls but the differences were not statistically significant. Using a plethysmographic technique we found a significantly lower venous volume of the forearm in the offspring than in controls. There was, however, no effect of ouabain on the venous volume. The decreased venous distensibility among normotensive offspring might be an early manifestation of essential hypertension.
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Ohlsson O. Venous volume and blood flow in hand at rest and during psychological stress in male relatives to hypertensive patients. ACTA MEDICA SCANDINAVICA 2009; 212:343-6. [PMID: 7180586 DOI: 10.1111/j.0954-6820.1982.tb03226.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A total of 19 male relatives to hypertensive individuals were examined with regard to blood flow and venous volume in the hand at rest and during a psychological stress test. They were compared to 19 male controls without heredity for hypertension. There were no significant differences between the groups in hand blood flow or venous volume either at rest or during the test. The increase in vascular resistance during psychological stress was significantly higher in relatives than in controls. Possible mechanisms behind the differences in arterial vascular reactivity between the groups are discussed.
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Ohlsson O, Henningsen NC, Hood B. Plasma volume and plasma volume distribution at rest, during muscular work, cold pressure test and psychological stress in male offspring from families with heavy aggregation of hypertension. ACTA MEDICA SCANDINAVICA 2009; 212:337-41. [PMID: 7180585 DOI: 10.1111/j.0954-6820.1982.tb03225.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Total and central plasma volume was measured in 51 male offspring of hypertensive individuals belonging to families with a history of essential hypertension for at least two generations. They were compared to 38 age-matched individuals without known hypertension in their families for at least two generations. Central plasma volume was determined at rest and during muscle work, cold pressure test and psychological stress. The offspring had significantly lower total plasma volume than the controls. Central plasma volume was equal in offspring and controls. The quotient central/total plasma volume was thus higher in offspring than in controls, and the difference was statistically significant during psychological stress and dynamic muscle work. Possible reasons for the differences between offspring and controls are an increased transcapillary escape of plasma, an increased quotient intracellular/extracellular fluid and/or increased tone of the capacitance vessels.
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López-Hernández FJ, López-Novoa JM. The lord of the ring: mandatory role of the kidney in drug therapy of hypertension. Pharmacol Ther 2005; 111:53-80. [PMID: 16154201 DOI: 10.1016/j.pharmthera.2005.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Accepted: 08/01/2005] [Indexed: 12/21/2022]
Abstract
Strong evidence supports the idea that total peripheral resistance (TPR) is increased in all forms of human and experimental hypertension. Although the etiological participation of TPR in the origin and long-term maintenance of hypertension has been extensively debated, it now seems clear that the renal, nonadaptive, infinite gain-working, pressure-sensitive natriuresis and diuresis is the main mechanism of blood pressure control in the long term. The tissue, cellular, biochemical, and genetic sensors and executors of this process have not been fully identified yet, but the role of the renal medulla has gained growing attention as the physiopathological scenario in which the key regulatory elements reside. Specifically, the functionality of the renomedullary vasculature seems to be highly responsible for blood pressure control. The vasculature of the renal medulla becomes a new and more specific target for the therapeutic intervention of hypertension. Recent data on the effect of baroreceptor-controlled renal sympathetic activity on the long-term regulation of blood pressure are integrated. The renomedullary effects of the main antihypertensive drugs are discussed, and new perspectives for the therapeutic intervention of hypertension are outlined. Comparison of the genetic program of the renal medulla before and after the development of hypertension in spontaneously hypertensive and experimentally induced animal models might provide a mechanism for identifying the key genes that become activated or suppressed in the development of high blood pressure. These genes, their encoded proteins, or other elements related to their signalling and genetic pathways might serve as new and more specific targets for the pharmacological treatment of abnormally elevated blood pressure. Besides, proteins specifically located to the luminal side of the renomedullary vascular endothelium may serve as potential targets for site-directed drug and gene therapy.
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Affiliation(s)
- Francisco J López-Hernández
- Unidad de Investigación, Hospital Universitario de Salamanca, Paseo de San Vicente, 58-182, 37007 Salamanca, Spain.
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Lopes HF, Silva HB, Consolim-Colombo FM, Barreto Filho JA, Riccio GM, Giorgi DM, Krieger EM. Autonomic abnormalities demonstrable in young normotensive subjects who are children of hypertensive parents. Braz J Med Biol Res 2000; 33:51-4. [PMID: 10625874 DOI: 10.1590/s0100-879x2000000100007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Although a slightly elevated office blood pressure (BP) has been reported in several studies, little is known about the prolonged resting blood pressure, heart rate (HR) and baroreflex sensitivity (BRS) of prehypertensive subjects with a family history of hypertension. Office blood pressure, prolonged resting (1 h) BP and HR were measured in 25 young normotensives with a positive family history of hypertension (FH+) and 25 young normotensives with a negative family history of hypertension (FH-), matched for age, sex, and body mass index. After BP and HR measurements, blood samples were collected for the determination of norepinephrine, plasma renin activity and aldosterone levels, and baroreflex sensitivity was then tested. Casual BP, prolonged resting BP and heart rate were significantly higher in the FH+ group (119.9 +/- 11.7/78.5 +/- 8.6 mmHg, 137.3 +/- 12.3/74.4 +/- 7.9 mmHg, 68.5 +/- 8.4 bpm) compared to the FH- group (112.9 +/- 11.4/71.2 +/- 8.3 mmHg, 128.0 +/- 11. 8/66.5 +/- 7.4 mmHg, 62.1 +/- 6.0 bpm). Plasma norepinephrine level was significantly higher in the FH+ group (220.1 +/- 104.5 pg/ml) than in the FH- group (169.1 +/- 63.3 pg/ml). Baroreflex sensitivity to tachycardia (0.7 +/- 0.3 vs 1.0 +/- 0.5 bpm/mmHg) was depressed in the FH+ group (P<0.05). The FH+ group exhibited higher casual blood pressure, prolonged resting blood pressure, heart rate and plasma norepinephrine levels than the FH- group (P<0.05), suggesting an increased sympathetic tone in these subjects. The reflex tachycardia was depressed in the FH+ group.
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Affiliation(s)
- H F Lopes
- Unidade de Hipertensão, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
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Blood pressure responses to stress: Relation to left ventricular structure and function. Ann Behav Med 1996; 18:61-6. [DOI: 10.1007/bf02903941] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Miller SB, Turner JR, Sherwood A, Brownley KA, Hinderliter AL, Light KC. Parental history of hypertension and cardiovascular response to stress in black and white men. Int J Behav Med 1995; 2:339-57. [PMID: 16250772 DOI: 10.1207/s15327558ijbm0204_4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
White offspring of hypertensives typically exhibit an elevated cardiovascular response to stress. Studies of Black offspring of hypertensives have been fewer, with inconsistent results. This may be due, in part. to incomplete characterizations of hemodynamic responses. This study examines cardiovascular reactivity in Black and White offspring of hypertensives with a particular focus on vascular resistance responses. A total of 62 healthy normotensive men, 41 with a parental history of hypertension (PH+: 21 Blacks, 20 Whites), and 21 without parental hypertension (PH-: 7 Blacks, 14 Whites) engaged in a series of laboratory tasks. Both Black and White PH+ participants exhibited elevated diastolic blood pressure (DBP) responses, but to different patterns of stressor tasks. Familial differences in total peripheral resistance response were also obtained for Black and White participants in a comparison across all tasks, but were particularly evident in tasks when PH+ participants had elevated DBP responses. These results suggest that a parental history of hypertension is an important moderator of cardiovascular, and in particular peripheral vascular, responses to stress in Black and White individuals.
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Affiliation(s)
- S B Miller
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
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Miller SB. Parasympathetic nervous system control of heart rate responses to stress in offspring of hypertensives. Psychophysiology 1994; 31:11-6. [PMID: 8146249 DOI: 10.1111/j.1469-8986.1994.tb01019.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The elevated heart rate response to stress in normotensive offspring of hypertensives (PH+) has been suggested to be a function of sympathetic nervous system activity. This study examined whether parasympathetic nervous system activity may also underlie familial differences in the heart rate response. Twenty-four subjects, half of whom were PH+, were exposed to four stressor tasks administered in counterbalanced order. Stressors were chosen based on previous research that suggested vagal contributions to the heart rate response. Stressors were a cold pack to the forehead, isometric hand grip, a noxious film, and a shock-avoidance video game task. Physiological measures included heart rate (HR), respiration rate (RR), and respiratory sinus arrhythmia (RSA). RSA values were corrected for corresponding RR by analysis of covariance. Familial differences in HR were observed in response to the hand grip and video game tasks. However, in both cases analyses suggest that familial differences in reactivity were a function of primarily sympathetic as opposed to parasympathetic influences. Familial differences in RSA were not observed for rest or tasks. This study found no evidence for parasympathetic mediation of familial differences in the heart rate response to the stressors employed.
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Affiliation(s)
- S B Miller
- Department of Psychology, Concordia University, Montreal, Canada
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van Hooft IM, Grobbee DE, Waal-Manning HJ, Hofman A. Hemodynamic characteristics of the early phase of primary hypertension. The Dutch Hypertension and Offspring Study. Circulation 1993; 87:1100-6. [PMID: 8462138 DOI: 10.1161/01.cir.87.4.1100] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The hemodynamic characteristics of the early phase of primary hypertension are subject to debate. In particular, it remains unclear whether an increased vascular peripheral resistance or a raised cardiac output is involved as the primary hemodynamic alteration in hypertension. METHODS AND RESULTS We studied hemodynamic characteristics and oxygen consumption in relation to 24-hour ambulatory blood pressure measurements in three groups of normotensive children with a different familial predisposition for hypertension. Selection of participants was based on parental blood pressure levels. Mean 24-hour blood pressure was higher in the offspring of two hypertensive parents compared with the offspring of two normotensive parents; there was a difference of 4.7 mm Hg (95% confidence interval [CI], 1.8-7.6) for systolic blood pressure and a difference of 4.8 mm Hg (CI, 2.3-7.3) for diastolic blood pressure. The 24-hour blood pressure pattern was consistently at a higher level for both systolic and diastolic blood pressures in the offspring of two hypertensive parents compared with the offspring of two normotensive parents. The smallest differences in blood pressure were seen at night, and the largest differences in blood pressure between the groups of offspring were seen during periods of physical activity. Echocardiographic examination combined with registration of oxygen consumption did not show a difference in cardiac index and arteriovenous oxygen difference between the study groups. However, differences in cardiac dimensions were apparent, with an increased left ventricular mass index (8.7 g/m2; CI, 2.4-15.0) in the offspring of two hypertensive parents. CONCLUSIONS These findings do not support the existence of a hyperkinetic circulatory phase but may indicate the presence of an increased left ventricular mass in early primary hypertension.
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Affiliation(s)
- I M van Hooft
- Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands
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Parati G, Ravogli A, Giannattasio C, Mutti E, Trazzi S, Villani A, Mancia G. Changes in 24 hour blood pressure and in cardiac and vascular structure in normotensive subjects with parental hypertension. CLINICAL AND EXPERIMENTAL HYPERTENSION. PART A, THEORY AND PRACTICE 1992; 14:67-83. [PMID: 1541048 DOI: 10.3109/10641969209036172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Subjects with family history of hypertension represent a suitable model to investigate the mechanisms responsible for early cardiovascular structural and functional changes occurring in essential hypertension. In our study we have addressed the factors involved in determining the mild elevation in office blood pressure frequently observed in normotensive subjects with hypertensive parents. In 15 normotensive subjects with both parents hypertensive (FH++) and in 15 normotensive subjects with one parent hypertensive (FH(+)-) we found no evidence of a hyperreactivity to stress as compared to the responses of 15 normotensive subjects with no parental hypertension (FH--). On the contrary FH++ subjects were characterized by a significant although mild increase in their blood pressure values recorded either at rest and in ambulatory conditions over the 24 hours, including night sleep. FH++ and FH(+)- subjects also showed a greater left ventricular mass thickness and a greater minimal forearm vascular resistance than FH-- subjects. Thus, the elevation in blood pressure found in the pre-hypertensive stage in subjects with positive family history for hypertension does not reflect a hyperreactivity to the stress associated with physician's visit but indicates an early and persistent blood pressure elevation. This blood pressure elevation is accompanied by early cardiovascular structural changes which may indicate that these subjects are exposed to a higher risk even before developing overt hypertension.
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Affiliation(s)
- G Parati
- Cattedra di Semeiotica Medica, Ospedale Maggiore, Milano, Italy
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Ravogli A, Trazzi S, Villani A, Mutti E, Cuspidi C, Sampieri L, De Ambroggi L, Parati G, Zanchetti A, Mancia G. Early 24-hour blood pressure elevation in normotensive subjects with parental hypertension. Hypertension 1990; 16:491-7. [PMID: 2228148 DOI: 10.1161/01.hyp.16.5.491] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Subjects with a family history of parental hypertension are reported to have a slightly higher office blood pressure in the prehypertensive stage. Whether this reflects a hyperreactivity to blood pressure measurement or a more permanent blood pressure elevation, however, is not known. In the present study, blood pressure was measured in 15 normotensive subjects whose parents are both hypertensive (FH++), 15 normotensive subjects with one hypertensive parent (FH(+)-), and 15 normotensive subjects whose parents are not hypertensive (FH--); among the three groups, subjects were matched for age, sex, and body mass index. The measurements were made in the office during a variety of laboratory stressors and during a prolonged resting period, and for a 24-hour period (ambulatory blood pressure monitoring). Office blood pressure was higher in the FH++ group than in the FH-- group (p less than 0.05). The pressor responses to laboratory stressors were similar in the two groups, but the FH++ group had higher prolonged resting and 24-hour blood pressure than the FH-- group; the difference was always significant (p less than 0.05) for systolic blood pressure. The FH++ group also had a greater left ventricular mass index (on echocardiographic examination) than the FH-- group (p less than 0.01). The blood pressure values and echocardiographic values of the FH(+)- group tended to be between those of the other two groups. Thus, the higher blood pressure shown by individuals in the prehypertensive stage with a family history of parental hypertension does not reflect a hyperreactivity to stress but an early permanent blood pressure elevation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Ravogli
- Centro Auxologico Italiano, Ospedale Maggiore, Milano
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Weidmann P. Pathogenetic and therapeutic relevance of cardiovascular pressor reactivity to norepinephrine in human hypertension. CLINICAL AND EXPERIMENTAL HYPERTENSION. PART A, THEORY AND PRACTICE 1989; 11 Suppl 1:257-73. [PMID: 2663249 DOI: 10.3109/10641968909045430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In normotensive humans with a positive family history of essential hypertension, blood pressure (BP) is often dysregulated. Body sodium, blood volume, plasma angiotensin II (AngII), epinephrine and norepinephrine (NE), their responses to changes in sodium intake or posture, as well as baroreflex function, beta-receptor-mediated cardiac responsiveness, and the responsiveness of BP to AngII appear to be largely unaltered. However, the responsiveness of BP to NE is commonly exaggerated. An increase in potassium intake may improve the NE hyperreactivity and concomitantly lower BP within the "normotensive" range. Therefore, a selective vascular NE hyperreactivity relative to existing sympathetic activity seems to be a common familial abnormality predisposing for the development of essential hypertension. In borderline or established essential hypertension, an inappropriate vascular reactivity relative to sympathetic activity probably complements other mechanisms contributing to the maintenance of hypertension. Various antihypertensive treatments may lower BP at least in part by improving cardiovascular NE (hyper)reactivity without provoking an equivalent rise in sympathetic activity. These include dietary potassium supplementation, thiazide-type agents, indapamide, calcium channel blockers, postsynaptic alpha 1-blockers, and AngII converting enzyme inhibitors.
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Affiliation(s)
- P Weidmann
- Medizinische Poliklinik, University of Berne, Switzerland
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Mittal SR, Sethi JP, Sethi AK, Bharadwaj B. The resting surface electrocardiogram as a predictor of future hypertension. Int J Cardiol 1988; 18:41-52. [PMID: 3343063 DOI: 10.1016/0167-5273(88)90029-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Resting supine and post-provocation (dynamic exercise, isometric exercise and cold pressor) levels of blood pressure were measured in 80 normotensive offspring of normotensive parents (control) and 55 normotensive offspring of parents with essential hypertension. The surface electrocardiogram (including conventional twelve leads, posterior chest leads, right-sided chest leads and bipolar precordial leads) was also recorded in all subjects. Twenty-eight offspring of parents with essential hypertension had their resting and/or post-provocation blood pressure above the upper limit of standard deviation in age- and sex-matched control group. Flat or upright T waves, with either S waves less than 0.2 mV, or S/R ratio less than 2, or T waves equal to or higher than the accompanying R waves in lead V4R, could identify these potential hypertensives with nearly 90% specificity and nearly 75% sensitivity. The criterion had been derived, however, by analysis of the data achieved retrospectively. Therefore, the exact discriminating value of this criterion can be assessed only by a long-term prospective study.
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Affiliation(s)
- S R Mittal
- J.L.N. Medical College and Hospital, Ajmer, Rajasthan, India
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Ditto B. Parental history of essential hypertension, active coping, and cardiovascular reactivity. Psychophysiology 1986; 23:62-70. [PMID: 3945709 DOI: 10.1111/j.1469-8986.1986.tb00596.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Gill JS, Beevers DG. The relationship of hypertension and its treatment with stress and well-being. ACTA ACUST UNITED AC 1985. [DOI: 10.1002/smi.2460010407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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